3 Big Reasons for Poor Urine Flow in Men and How Painless Tests Identifies the Cause

Poor Urine Flow in Men - NU Hospitals

It’s no secret that smartphones have become omnipresent companions, and the bathroom is no exception. Whether to know which trend the national stock market has shifted its gear to or the current score of the Indian Cricket team in ICC rankings, or even playing games can easily stretch a quick pit stop into a mini-vacation.

But honestly, don’t some men spend too much time in the washroom just to answer nature’s call? And what takes so long for them in the toilet? Sure, even women experience poor urine output. Also, if you ask a urology doctor, complaints of poor urine stream are seen more in men than women. There could be more than one reason for low urine output.

It’s more than a hair-pulling frustration when urine comes out slowly, especially if you are making your client wait during a quick washroom break in a conference meeting, having dinner with your family at restaurants, or simply grinding through the toiling day. 

But thankfully there is a diagnostic tool for understanding and determining the cause of urinary hesitancy which is Retrograde Urethrogram (RGU). 

Before getting into the details of RGU, covering its step-by-step procedure, and preparing for what to do before and after the procedure, let us understand the underlying reasons for improper urine flow.



Retrograde Urethrogram (RGU)- Procedure, Benefits, Results

  Causes of reduced urine force in men:

  •  Urethral Stricture: The urethra is the part of your body that carries urine and flows out of the body. But sometimes, this tube gets abnormally narrow. This condition is called urethral stricture disease. This narrowing of the urethra obstructs the flow of urine and shows up in dribbling or causes strain to the individual while passing urine.
  •  Prostate Enlargement: As men age, Prostate enlargement is commonly seen among men.  The prostate gland is located at the base of the urethra, when this gland enlarges, it presses against the urethra causing difficulty in urination. Although a non-life-threatening condition, it does have an impact on the urine flow.
  • Blockages in organs: It is not just the elderly population but also young men that can have poor flow due to a stricture, urethral valve or primary bladder neck obstruction.

Understanding Retrograde Urethrogram (RGU):

Retrograde Urethrogram (RGU) is a special X-ray procedure done to study the urethra to look for any abnormalities like stricture (narrowing) etc. It is done in males. If a narrowing is noted, the RGU is ideally followed up with a micturating cystourethrogram (MCU).

 Thus, RGU helps urology doctors identify the fundamental issue behind poor urinary flow in men.

 Preparation for RGU test: 

There is no need for any special preparation before this test. If you have an active infection of the urinary tract, indicated by a urine culture. You will need to be treated for this before undergoing this test.

Step-by-Step Procedure of RGU:

i)  Catheterization:

A local anaesthetic solution is first introduced through the urinary outlet, in the reverse direction to the normal urine flow.

 ii)  Contrast Injection: 

Following this, the contrast solution (which looks opaque on x-rays) is pushed in the same manner and this is captured on an x-ray film to document the findings. The contrast solution is injected into the urethra by placing a catheter at the tip of the penis. 

 iii) X-ray Imaging: 

Different X-ray views are taken during this procedure for doctors’ evaluation. 

 iv)  Any pain during the procedure?

No, the procedure does not involve any pain. While the local anesthesia solution is introduced you will have some discomfort. But if you have pain, immediately report to your doctor and the procedure may be abandoned. Very rarely you may have reactions to the contrast (or) the local anesthesia itself. Very rarely this can be life-threatening.

Problems during the procedure:

You may feel a burning sensation while passing urine and may pass slight blood-tinged urine once (or) twice following the test. In case the problems persist (or) you develop fever, or scrotal pain, then immediately report to your doctor.

After the procedure: 

You can ask the radiographer to email the report to your email address within 2 hours or you can collect a hard copy. A printed report will be available by the next 1 working day. A compact disc (CD) of the images can also be made available after 1 hour and is given at no extra cost.

Benefits of RGU X-ray procedure:

X-Ray retrograde urethrogram or micturating cystourethrogram (RGU/MCU) is a very informative X-ray test.  It aids in diagnosing urethral and bladder problems and guides treatment decisions. RGU is a safe and effective procedure for diagnosing poor urine flow in men.


An early diagnosis helps to address low urine output problems by consulting a urology specialist. Are you content with your urine flow? If not, connect with NU Hospitals on social media platforms or contact us to schedule an appointment.

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